Interim Statement Research Articles

The association of multidimensional frailty with metabolic syndrome and low-grade inflammation in community-dwelling older adults in the Netherlands: a Lifelines cohort study.

Preventing metabolic syndrome (MetS) and frailty in older adults is crucial for healthy aging. The association between MetS and physical frailty is well-documented, with low-grade inflammation as potential explanation. However, the association between MetS and frailty as a multidimensional concept, and the association of low-grade inflammation with presence of MetS and frailty, is yet unclear. Therefore, we examined these associations low-grade inflammation in a large cohort of community-dwelling older adults. This cross-sectional study was performed among adults aged ≥ 65 years enrolled in the Dutch Lifelines population cohort. MetS was defined according to the Joint Interim Statement of 2009. Frailty was measured by the Groningen Frailty Indicator (GFI), which consists of 15 self-reported items on both physical and psychosocial functioning, with a score ≥ 4 indicating presence of frailty. The association between MetS and its five components and frailty was assessed using logistic regression models. Low-grade inflammation was represented by high-sensitivity C-reactive protein (hsCRP) level. The association of hsCRP level with presence of MetS and frailty was assessed using multinomial logistic regression in a sub-cohort with available hsCRP measurements. Of 11,552 adults (52.1% women) included, the prevalences of MetS and frailty were 28% and 15%, respectively. MetS was positively associated with frailty after adjusting for relevant covariates (OR: 1.37; 95% CI: 1.22-1.53). MetS components elevated blood pressure was most strongly associated with frailty. In the sub-cohort of 3896 participants, high hsCRP was associated with presence of MetS and frailty (OR: 1.31; 95% CI: 1.15-1.51), and MetS alone (OR: 1.44; 95% CI: 1.33-1.56), but not to frailty alone. A higher hsCRP level was associated with a higher score on the physical domain of frailty (b: 0.06; 95% CI: 0.03-0.08). Presence of MetS is associated with presence of frailty indicated by a multidimensional index in a large group of Dutch older adults. Low-grade inflammation, indicated by plasma hsCRP level, was found to be associated with both presence of MetS and frailty and presence of MetS alone. Increased hsCRP levels were associated with the physical component of frailty, but not with frailty as a multidimensional concept.

Correlation of obesity indices with metabolic syndrome among Igbos in Enugu and their optimal cut-off points

Background: Metabolic syndrome also known as insulin resistance syndrome or Syndrome X, represents an association of risk factors for cardiovascular disease and type 2 diabetes mellitus. Its central diagnostic criteria include obesity, impaired fasting glucose, low HDL-cholesterol; elevated triglycerides levels and high blood pressure. Insulin resistance is believed to be the main cause of Metabolic Syndrome and is connected to the level of visceral or intra-abdominal adipose tissue, which could be assessed either by calculating body mass index or by measuring waist circumference. Objectives: This study aimed at determining the correlation of indices of obesity with metabolic syndrome among Igbos in Enugu and their optimal cut-off points. Method: This was a cross-sectional community-based descriptive survey carried out in Enugu Metropolis involving 469 apparently healthy adult volunteers age range 18-75 screened for metabolic syndrome using the Joint Interim Statement definition. Stratified random sampling technique was used in the selection of participants. The data obtained were coded and analyzed into percentages, mean and standard deviation using the Statistical Package for Social Sciences (SPSS), version 23. t-test was used to compare continuous variables for associations, while Youden index and Receiver Operating Characteristic analysis were used to determine optimal cut-off point of the obesity indices that best balances sensitivity and specificity of the obesity indices. Pearson correlation coefficient was used to examine correlation between obesity indices and cardiovascular risks. Statistical significance is set at p< 0.05 and 95% confidence interval. Result: The study revealed that all indices of obesity showed positive correlation with metabolic syndrome. BMI showed the least strength of correlation while WC is the best discriminator for predicting Metabolic Syndrome however, the optimal cut-off point of the obesity indices differ from the standard cut-off points. Conclusion: All the obesity indices used in the study showed positive correlation with metabolic syndrome however, WC is to be preferred in screening for metabolic syndrome. The optimal cut-off point obtained can be applied specifically for Igbos in Enugu

The Significance of Comprehensive Metabolic Phenotypes in Cancer Risk: A Japan Multi-Institutional Collaborative Cohort (J-MICC) Study.

The present study investigated the relationship between metabolic phenotypes and the risk of cancer in a Japanese population using the criteria of metabolic phenotypes based on an examination and those based on questionnaires. We used data from 25,357 subjects for examination-based analyses and those from 53,042 subjects for questionnaire-based analyses in the Japan Multi-Institutional Collaborative Cohort Study. Metabolic phenotypes were defined by classifying subjects according to their BMI (obesity: BMI ≥25 kg/m2; normal weight: BMI <25 kg/m2) and the number of metabolic abnormalities. Metabolic abnormalities were defined according to metabolic syndrome components of the Joint Interim Statement Criteria for examination-based analyses and self-reported histories of diabetes, dyslipidemia, and hypertension for questionnaire-based analyses. Cox proportional hazards regression analyses adjusted for potential confounders were performed for total and site-specific cancer incidence according to metabolic phenotypes. Metabolically unhealthy obesity (MUHO) was significantly associated with cancer incidence in both examination-based [HR (95% CI): 1.17 (1.01-1.36)] and questionnaire-based analyses [HR (95% CI): 1.15 (1.04-1.26)]. Regarding site-specific cancer in questionnaire-based analyses, metabolically healthy obesity and MUHO were associated with colorectum and liver cancers in all subjects and with breast cancer in female subjects. Subjects with a metabolically unhealthy normal weight had a higher risk of pancreatic cancer. Moreover, MUHO was associated with corpus uteri cancer in female subjects. This prospective cohort study suggests that metabolic phenotypes are important risk factors for total and some site-specific cancers in Japanese adults.

Telomere length across spectrum of metabolic health

Abstract Introduction Telomere length is a marker of cellular aging and is correlated with various cardiovascular risk factors. Aim To assess the association between obesity, metabolic syndrome (MetS) and telomere length. Methods The LIPIDOGEN study was carried out in the primary care 2015. Patients recruited to LIPIDOGEN cohort (n=1788) were a random subset of patients from LIPIDOGRAM 2015 (n=13,724) study. Patients for LIPIDOGRAM2015/LIPIDOGEN study were recruited in all 16 administrative regions in Poland and physicians were proportionally distributed to the number of inhabitants in each administrative region. Each patient was asked to fill the questionnaire on risk factors, chronic diseases, treatments and lifestyle and also had saliva secured for DNA analyses. Recruited patients were divided into four groups based on the presence of MetS: 1) HS – healthy slim 2) MHO – metabolically healthy obese 3) NOMS – Non-obese with MetS 4) MUO – metabolically unhealthy obese. MetS was diagnosed basing on Joint Interim Statement 2009 criteria. Relative telomere length (rTL) was measured using quantitative polymerase chain reaction. Results DNA quality was sufficient for further analyses in 1606 patients. After removing of outliers, 1342 patients (Females - 59.3%, mean age- 50.2 years) were included for further analyses (HS-488, MHO-180, NOMS-165, MUO-509). Increase in BMI, waist circumference, frequency of diabetes mellitus, hypertension, dyslipidemia and history of myocardial infarction moving from HS to MUO was observed. (Table 1.). MUO group exhibited the highest triglycerides and lowest HDL-C levels. RTL length, an indicator of cellular aging, was inversely correlated with metabolic health, being shortest in the NOMS and MUO groups, which may indicate a link between metabolic health and accelerated biological aging. Conclusions Telomere length is shorter in patients with obesity as compared to lean patients even without the presence of MetS. Telomere length in patients with MetS, regardless of concomitant obesity, is shorter than in patients without MetS. Figure 1. Telomere length across metabolic health categories. Table 1. Clinical characteristics of the study participants.Figure. 1.Table. 1.

Fruit and vegetable intake modifies the association between ultra-processed food and metabolic syndrome

BackgroundThis prospective cohort study aimed to investigate the association between ultra-processed food (UPF) and the risk of metabolic syndrome (MetS), as well as to assess whether fruit and vegetable intake and weight change modify this association.MethodsWe included 1915 healthy participants who participated in the Tehran Lipid and Glucose Study (TLGS), all of whom had complete demographic, anthropometric, and dietary measurements. A validated food frequency questionnaire was used to assess UPF consumption based on the NOVA classification system. MetS was defined according to the Joint Interim Statement. Multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) for MetS events across tertiles of UPF. The effect of fruit and vegetable consumption and weight change on this association was assessed using joint classification by Cox regression.ResultsUFP consumption showed no association with MetS risk after adjusting for confounders. However, after adjustment for dietary fiber, fruits, and vegetables, the highest tertile of UPF consumption was positively linked to MetS risk, compared to the lowest tertile. There was a significant interaction between fruit, vegetable, and dietary fiber intake and UPF consumption concerning the risk of MetS (All P values < 0.05). Among individuals consuming less than 248 g/day of fruit, the risk of MetS increased by 54% (confidence interval: 1.13–2.10) in the highest UPF tertile. Consuming vegetables and dietary fiber below the median (258 g/day and 42.2 g/day, respectively) increased the risk of MetS in the third tertile of UPF. However, consuming vegetables and fiber ≥ median intake, reduced the risk of MetS among those with the lowest UPF consumption. Furthermore, the risk of MetS was observed in the third tertile of UPF consumption among individuals with fruit and vegetable consumption < 537 g/day. UPF consumption was not associated with the risk of MetS in different weight change statuses.ConclusionsConsuming more fruits and vegetables mitigated the adverse effect of UPF on the risk of developing MetS.

Comparison of associations between alcohol consumption and metabolic syndrome according to three definitions: The Swedish INTERGENE study

BackgroundWhile prevalence estimates differ by definition of metabolic syndrome (MetS), it is less clear how different definitions affect associations with alcohol consumption. MethodsWe included 3051 adults aged 25–77 from the baseline examination of the Swedish INTERGENE cohort (2001–2004). Using multiple logistic regression, we investigated cross-sectional associations between ethanol intake and MetS defined according to the Adult Treatment Panel III (ATP III), the International Diabetes Federation (IDF), and the Joint Interim Statement (JIS). Alcohol exposure categories comprised abstinence, and low, medium, and high consumption defined via sex-specific tertiles of ethanol intake among current consumers. Covariates included sociodemographics, health, and lifestyle factors. ResultsMetS prevalence estimates varied between 13.9 % (ATP III) and 25.3 % (JIS), with higher prevalence in men than women. Adjusted for age and sex, medium-high alcohol consumption was associated with lower odds of MetS compared to low consumption, while no difference was observed for abstainers. Only the most specific (and thus severe) definition of MetS (ATP III) showed decreasing odds for ethanol intake when adjusted for all covariates. ConclusionOur study shows that alcohol-related associations differ by definition of MetS. The finding that individuals with the most stringently defined MetS may benefit from alcohol consumption calls for further well-controlled studies.

C-reactive protein to albumin ratio and risk of incident metabolic syndrome in community-dwelling adults: longitudinal findings over a 12-year follow-up period.

The C-reactive protein to albumin (CRP/Alb) ratio has emerged as a novel biomarker for various inflammatory diseases. This study aimed to evaluate the association between the CRP/Alb ratio and incident metabolic syndrome (MetS) with a large-sample, community-based Korean cohort over a 12-year follow-up period. Among 10,030 participants, a total of 6205 participants aged 40-69 years without MetS were selected from the Korean Genome and Epidemiology Study (KoGES). The baseline CRP/Alb ratio was divided into quartiles. The definition of newly developed MetS was the one proposed by the 2009 Joint Interim Statement of Circulation. Hazard ratios (HRs) with 95% confidence intervals (CIs) for incident MetS were calculated using multivariable Cox proportional hazards regression models after adjusting for potentially confounding variables. During the 12-year follow-up period, MetS developed in 2535 subjects (40.9%, 2535/6205) with an incidence rate of 5.6-11.9 (over 2 years). Compared to the reference first quartiles, the HRs (95% CIs) of incident MetS in the second, third, and fourth quartiles increased in a dose-response manner. Compared to the reference quartile, the HRs (95% CIs) of the incidence of MetS for the second, third, and fourth quartiles of CRP/Alb ratio were 1.12 (0.99-1.27), 1.24 (1.11-1.40), and 1.51 (1.34-1.69) after adjusting for age, sex, smoking status, alcohol intake, physical activity, total cholesterol, mean arterial pressure, HOMA-IR, and total energy intake. High CRP/Alb ratio at baseline may be a useful surrogate indicator of future incident MetS.

Cardiometabolic Health in Pregnancy and Postpartum: Findings From a Prospective Cohort Study in South Africa.

The cardiometabolic impact of HIV infection and treatment with antiretroviral therapy (ART) in pregnancy and the postpartum period remains unclear. We enrolled pregnant persons with (PHIV) and without HIV in Cape Town, South Africa, who were ≥18 years old at 24-28 weeks' gestation and followed them up to 32 months postpartum. We estimated associations between HIV status and cardiometabolic risk including body mass index (BMI), obesity (BMI ≥30 kg/m2), blood pressure (BP; elevated systolic BP ≥130 and/or diastolic ≥85 mmHg), lipid levels, and metabolic syndrome according to the Joint Interim Statement criteria using multivariable log binomial or linear regression models. Subgroup analyses compared PHIV on efavirenz (EFV)- vs dolutegravir (DTG)-based ART. Among 400 participants (n = 200 without HIV, n = 200 PHIV), 52% had prepregnancy obesity and 9% had elevated BP. Postpartum, 57% were classified with obesity, 31% had elevated BP, and 29% had metabolic syndrome. In multivariable analyses, HIV was associated with a lower BMI prepregnancy but not postpartum; however, mean indices were in the obese range regardless of HIV status. Neither BMI nor obesity prepregnancy or postpartum differed by ART regimen. Among PHIV, participants on DTG had higher levels of elevated BP in pregnancy and postpartum, compared with PHIV on EFV. We observed high levels of obesity, elevated BP, and metabolic syndrome in the perinatal period but few differences by HIV status. Participants on DTG may be more likely to have elevated BP in pregnancy and postpartum. Monitoring of cardiometabolic health for pregnant persons on DTG is warranted.

Combined Influence of Eight Lifestyle Factors on Metabolic Syndrome Incidence: A Prospective Cohort Study from the MECH-HK Study.

Although previous studies have shown significant associations between individual lifestyles and metabolic syndrome, limited studies have explored the combined effect of lifestyles. The purpose of this study was to investigate whether a combined lifestyle score was associated with metabolic syndrome incidence in Hong Kong Chinese women. This prospective cohort study included 1634 women (55.9 ± 8.6 years) without baseline metabolic syndrome, diabetes, myocardial infarction, or stroke. Eight lifestyle factors (smoking, physical activity, sedentary time, sleep, stress, fatigue, diet, and alcohol) were included by assigning 0 (unhealthy) or 1 point (healthy). The overall score was the sum of these points, ranging from 0 (the least healthy) to 8 points (the healthiest). Metabolic syndrome was diagnosed by the joint interim statement. During a 1.16-year follow-up, 179 (11.0%) new metabolic syndrome cases were identified. The incidences for the 0-3-point, 4-point, 5-point, and 6-8-point groups were 12.8% (79/618), 11.5% (42/366), 9.4% (29/309), and 8.5% (29/341), respectively. Compared to the lowest combined lifestyle score group, the highest group had a 47% reduced metabolic syndrome incidence, with an adjusted odds ratio and 95% confidence interval of 0.53 (0.33-0.86) (p = 0.010). These findings indicate that a higher combined lifestyle score was associated with a lower metabolic syndrome incidence in this population.

Metabolic syndrome and breast cancer risk

BackgroundLimited data are available on metabolic syndrome and its relation to breast cancer risk in Egypt. We aimed to study metabolic syndrome and its individual components as risk of breast cancer.MethodsThis case–control study recruited 112 breast cancer cases and 112 age-matched controls from Assiut University. In addition to demographic, clinical, and anthropoemetric characteristics, blood samples were collected from both study groups to evaluate metabolic syndrome and its individual components.ResultsMean age of breast cancer cases and control groups was 46.10 ± 4.34 and 45.66 ± 4.68 years, respectively. According to Joint Interim Statement (JIS) criteria for clinical diagnosis of metabolic syndrome, the overall prevalence of metabolic syndrome in all participants was 42.9%, and prevalence in breast cancer cases and control group was 57.14% and 28.6%, respectively, OR 33.33, 95% CI (1.91–5.81). BMI was more likely to be higher in breast cancer patients with a linear trend, p < 0.001. For individual components of metabolic syndrome, breast cancer cases were more likely to have high fasting blood glucose level, systolic and/or diastolic blood pressure, high triglycerides level, and low HDL-C as compared to the control group.ConclusionMetabolic syndrome and its components were found to be associated with the risk of breast cancer. We believe that prevention or reversal of metabolic syndrome by raising community awareness for lifestyle changes could be an effective way in minimizing the toll of the disease.

Blood pressure status in patients with metabolic syndrome

Relevance. Metabolic syndrome (MetS) is existence of many abnormalities, such as abdominal obesity, hypertension, dyslipidemia, and glucose intolerance. The occurrence of MetS in hypertensive people is linked to poorly managed hypertension. One of the parameters for the diagnosis of the syndrome is the presence of increased blood pressure; nevertheless, research shows that MetS patients are likely to experience hypertension often. Materials and Methods. 300 metabolic subjects were selected from the medicine OPD as study participants based on the joint interim statement’s 2009 definition of the metabolic syndrome. They were divided into three groups (normotensive, pre-hypertensive, and hypertensive) based on blood pressure readings that met the American Heart Association’s (AHA) Asian blood pressure criteria. The following parameters were recorded for data collection: anthropometric (Weight, Height, Body Mass Index Waist Hip Ratio), Blood pressure, biochemical (Fasting blood glucose, Lipid profile parameters). Results and Discussion. According to the resting blood pressure readings, out of 300 metabolic syndrome participants, 37 were normotensive [male (40.54 %); female (59.45 %)], 115 were pre-hypertensive [male (58.26 %); female (41.74 %), and 148 were hypertensive [male (52.7 %); female (47.3 %)]. In several parameters, there was no such significant difference between male and female participants across all groups. However, the levels of blood total cholesterol, triglycerides, and low-density lipoprotein were considerably greater in hypertensive and pre-hypertensive metabolic participants than in normotensive subjects, while the levels of high-density lipoprotein were lower. Conclusion. Study findings suggest, hypertension and pre-hypertension were more prevalent in the group with metabolic syndrome. Additionally, hypertensives have a higher chance of manifesting dyslipidemia.

Sex-specific-evaluation of metabolic syndrome prevalence in Algeria: insights from the 2016–2017 non-communicable diseases risk factors survey

Metabolic syndrome (MetS) is a core driver of cardiovascular diseases (CVD); however, to date, gender differences in MetS prevalence and its components have not been assessed in the Algerian adult general population. This study aimed to determine the gender differences in MetS prevalence and its components, in the general population of Algeria. Secondary analysis was performed on data from the Algerian 2016–2017 non-communicable disease risk factor survey. MetS was determined according to the harmonized Joint Interim Statement criteria. A Poisson regression model based on Generalised Estimating Equations was used to estimate the adjusted prevalence ratios (aPR) for the sex-specific factors associated with MetS. Overall, the prevalence of MetS was 34.0% (95% CI 32.4–35.6). MetS prevalence in women and men was 39.1% (95% CI 37.0–41.3) and 29.1% (95% CI 27.2–31.2), respectively. The most frequent triad was the clustering of abdominal obesity with low HDL-cholesterol and high blood pressure among women (8.9%; 95% CI [8.0–10.0]) and low HDL-cholesterol with high blood pressure and hyperglycaemia among men (5.2%; 95% CI [4.3–6.3]). Increasing age (aPR 3.21 [2.35–4.39] in men and aPR 3.47 [2.86–4.22] in women), cohabitation (aPR 1.14 [1.05–1.24]), women residing in urban areas (aPR 1.13 [1.01–1.26]), men with higher educational levels (aPR 1.39 [1.14–1.70]), and men with insufficient physical activity (aPR 1.16 [1.05–1.30]) were associated with higher risk of MetS. In this population-based study, one in three Algerian adults had MetS, and key components including abdominal obesity, low HDL-cholesterol, and high blood pressure, are very common, especially in women. Reinforcing interventions for weight management targeting married women living in urban areas and improving sufficient physical activity in men with higher socioeconomic status could provide maximal health gains and stem the CVD epidemic in Algeria.

To survey on the components of metabolic syndrome and determine the serum ferritin levels in patients with metabolic syndrome

Background: Metabolic syndrome is one of the most common public health concerns in the 21st century. Several studies in the world have shown a link between elevated serum ferritin and metabolic syndrome as well as the risk of metabolic syndrome, the study provides a number of conclusions argues that ferritin may be considered as an early predictor of metabolic syndrome. For that reason, we conducted this study with the objective: “To survey on the components of metabolic syndrome and determine the serum ferritin levels in patients with metabolic syndrome”. Methods: A descriptive, cross-sectional study on 207 patients who were treated at the General Internal Medicine-Geriatric Department, Hue Central Hospital from 5/2016 to 8/2017. Patients were divided into two groups: study group (104 patients with metabolic syndrome) and control group (103 patients without metabolic syndrome and no serum ferritin-mediated disease). The metabolic syndrome was diagnosed by joint interim statement of the International Diabetes Federation/American Heart Association/ National Heart, Lung, and Blood Institute/ World Heart Federation/ International Atherosclerosis Society/ International Association for the Study of Obesity 2009. Results: The most common combination of metabolic syndrome components was: hypertriglyceridemia - hypertension - hyperglycemia (15.1%). In the metabolic syndrome group, mean serum ferritin concentration was 391.62±181.97ng/ml (Increased ferritin concentration accounted for 86.54%). In men, mean serum ferritin concentration was 453.064 ± 161.75ng/ml (Increased ferritin concentration accounted for 96.15%). In women, mean serum ferritin concentration was 330.17 ± 181.71 ng/ml (Increased ferritin concentration accounted for 86.54%). Conclusion: In the group of patients with metabolic syndrome, the serum ferritin levels increases and the rate of Increased ferritin concentration was high.

The Association between Visit-to-Visit Variability of Blood Pressure and the Risk of Metabolic Syndrome: The Moderating Effect of Weight

Aims. Metabolic syndrome (MetS) affects approximately one-third of the global population. Visit-to-visit variability of blood pressure (VVV-BP) constitutes a substantial risk factor for numerous chronic conditions. Thus, this study aimed to assess the relationship between VVV-BP and MetS and identify potential moderating factors between these. Methods. Data were obtained from the China Health and Retirement Longitudinal Study, a nationally representative study. Multiple logistic regression analyses were utilized to explore the association between VVV-BP and MetS while incorporating moderation analyses. MetS was defined according to the criteria outlined in the Joint Interim Statement. VVV-BP was expressed by the standard deviation, coefficient of variation, average real variability, and root mean square error. Results. Individuals with the highest levels of VVV of systolic blood pressure (SBP) exhibited a 70% increased risk of MetS compared to those with the lowest levels (OR = 1.70, 95% CI = 1.31–2.21). In addition, they had a 41% increased risk of VVV of diastolic blood pressure (DBP) (OR = 1.41, 95% CI = 1.09–1.81). Notably, weight change status significantly influenced the relationship between VVV-BP and MetS (Pinteraction = 0.01). Conclusions. VVV-BP is a significant contributor to the risk of developing MetS. Importantly, individuals who experienced weight loss during the follow-up period did not face a significantly higher risk of developing MetS.

The association between metabolic syndrome and insulin resistance with risk of cardiovascular events in different states of cardiovascular health status.

The aim was to examine the joint effect of metabolic syndrome (MetS) and insulin resistance (IR) with ideal cardiovascular health (iCVH) status on incident cardiovascular diseases (CVDs). The study included 6,240 Iranian adults ≥30 years, free of prior cardiovascular disease. Ideal cardiovascular health was determined based on American Heart Association's Life Simple 7. Metabolic syndrome was defined according to the Joint Interim Statement Criteria, and insulin resistance was defined as HOMA-IR ≥1.85 in women and ≥2.17 in men. Multivariable Cox proportional hazard ratios (HRs) were applied to examine the impact of metabolic syndrome, and insulin resistance at various levels of iCVH status. During the median follow-up of 14.0 years, 909 cases of cardiovascular disease occurred. Metabolic syndrome and insulin resistance were significantly associated with incident cardiovascular disease events. In the poor and intermediate status, metabolic syndrome increased cardiovascular disease events with HRs of 1.83 and 1.57, respectively; the corresponding values for insulin resistance in the mentioned categories were 1.91 and 1.25, respectively (P values < 0.05). In the intermediate and poor iCVH status, hypertriglyceridemia was linked to a 40% and 35% higher risk of cardiovascular disease, the corresponding values for low HDL-C was 20% and 60%, respectively (P values < 0.05). Although adding metabolic syndrome, its dyslipidemia and insulin resistance to iCVH status in both poor and intermediate status significantly improve the prediction of cardiovascular disease using net reclassification improvement (P values < 0.05), the value of C-index did not change. Metabolic syndrome and the dyslipidemia component had a negligible but significant improvement in the prediction of cardiovascular disease among individuals with non-optimal iCVH status.

Brain-derived neurotrophic factor is associated with cardiometabolic risk factors in HIV patients on combination antiretroviral therapy in Ghana

BackgroundBrain-derived neurotrophic factor (BDNF) has been implicated in the development of cardiometabolic risk factors in some populations. However, few studies have investigated the role of BDNF and cardiometabolic risk factors in HIV patients despite the plethora of evidence linking HIV infection with the dysregulation of circulating BDNF levels. We investigated the association between serum BDNF and cardiometabolic risk factors in HIV patients in a primary hospital in Ghana. We recruited 450 participants, comprising 150 combination antiretroviral (cART)-treated HIV patients, 150 cART-naïve HIV patients, and 150 non-HIV controls. Data on sociodemographic parameters and medical history were collected using a structured questionnaire. Fasting venous blood samples were collected to measure plasma glucose levels, lipid profiles, and BDNF. Metabolic syndrome (MetS) was defined using the joint interim statement criteria.ResultsCompared to untreated HIV patients and uninfected controls, the proportion of participants having MetS was high in cART-exposed HIV patients (26.8% vs 21.1% vs 52.1%, respectively, p < 0.001). Generally, BDNF levels were higher in uninfected controls compared with untreated and cART-exposed HIV patients [7.1 (3.4–13.3) vs 4.9 (2.7–9.6) vs 5.6 (2.9–8.9) ng/ml, p = 0.025]. In participants without MetS, square root-transformed serum BDNF was lowest in cART-exposed HIV patients, followed by untreated HIV patients, with uninfected controls having the highest (1.8 ± 0.8 vs 2.4 ± 1.2 vs 2.9 ± 1.2 ng/ml, p < 0.001). MetS was associated with serum BDNF levels in only the cART-exposed HIV patients [OR (95% CI) = 2.98 (1.64–5.41), p < 0.001]. In cART-exposed HIV patients, an increase in BDNF was associated with increased likelihood of having impaired fasting glucose [2.49 (1.51–4.11), p < 0.001], high systolic blood pressure [1.64 (1.1–2.46), p = 0.016], and hypertriglyceridemia [2.73 (1.65–4.52), p < 0.001], as well as decreased likelihood of having low HDL cholesterol levels [0.32 (0.19–0.56), p < 0.001].ConclusionIn our study population, MetS was higher in cART-exposed HIV patients. HIV patients have low levels of serum BDNF, especially those without MetS. BDNF was associated with MetS and its components in HIV patients on cART management.

Prevalence of metabolic syndrome and metabolic dysfunction-associated fatty liver disease in Malaysia 2023: study protocol for a community-based nationwide cross-sectional survey

IntroductionMetabolic syndrome (MetS) is a cluster of cardio-metabolic dysfunctions characterised by increased fasting plasma glucose, waist circumference, blood pressure, triglycerides and reduction in high-density lipoprotein cholesterol. Meanwhile, metabolic dysfunction-associated fatty...

Association of baseline and changes in adiponectin, homocysteine, high-sensitivity C-reactive protein, interleukin-6, and interleukin-10 levels and metabolic syndrome incidence: Tehran lipid and glucose study

BackgroundMetabolic syndrome (MetS) is accompanied by chronic low-grade inflammation, and inflammatory markers like high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6), and homocysteine(Hcy) contribute to inflammation, obesity, and insulin resistance. Adiponectin(AdipoQ) and interleukin-10(IL-10) are anti-inflammatory markers that play protective roles in MetS. This study aimed to investigate the association between these biochemical marker changes and MetS in a sample of the Tehranian population during six years of follow-up. MethodsIn this longitudinal study, 340 adults at baseline and after a six-year follow-up, aged ≥18 years, were selected randomly from the Tehran Lipid and Glucose Study (TLGS). MetS was defined according to the Joint Interim Statement (JIS) criteria. Individuals were categorized into four groups based on their MetS status at baseline and follow-up: 1) non-MetS: participants who did not have MetS at both baseline and follow-up; 2) incident MetS: participants who did not have MetS at baseline but developed MetS during the follow-up ; 3) recovery MetS: participants who had MetS at baseline but no longer had MetS during the follow-up; 4) persistent MetS: participants who had MetS both at baseline and follow-up. ResultsThe mean follow-up time was 6.1 years. There were 176 subjects in the non-MetS group, 35 in the incident MetS group, 41 in the recovery MetS group, and 88 in the persistent MetS group. Increases in the levels of both hs-CRP 1.40 (95% CI: 1.15, 1.71, p = 0.001) and IL-6 1.09 (95% CI: 1.03, 1.17, p = 0.004) significantly increased the odds of the incident and persistent MetS, respectively. The area under the ROC curve (AUC) was more than 0.69 (p < 0.000) for hs-CRP in predicting MetS incidence and more than 0.86 (p < 0.000) for IL-6 in predicting MetS persistence. ConclusionAfter a six-year average follow-up, hs-CRP and IL-6 levels were deemed more reliable predictors of MetS incidence and persistence, respectively.

Differences in the components of metabolic syndrome by age and sex: a cross-sectional and longitudinal analysis of a cohort of middle-aged and older Japanese adults

BackgroundThe prevalence of metabolic syndrome (MetS) in Japan, a super-aged society, is increasing and poses a major public health issue. Several studies have reported sex differences in the association between age and MetS prevalence. This study aimed to examine the association between age and the prevalence of MetS based on multiple screening criteria and MetS components by sex.MethodsWe used 6 years of individual-level longitudinal follow-up data (June 2012 to November 2018; checkup year: 2012–2017) of middle-aged and older adults aged 40–75 years in Japan (N = 161,735). The Joint Interim Statement criteria, International Diabetes Federation criteria, and another set of criteria excluding central obesity were used as the screening criteria for MetS. The prevalence of MetS and MetS components was cross-sectionally analyzed according to sex and age. A longitudinal association analysis of age, MetS, and MetS components by sex was performed using a multilevel logistic model, adjusted for lifestyle- and regional-related factors.ResultsSex differences were observed in the prevalence and association of MetS and MetS components. In all age groups, the prevalence of central obesity was higher among women, and the prevalence of high blood pressure and fasting glucose was higher among men (P < 0.001). The prevalence of high triglyceride and low high-density lipoprotein cholesterol was higher among women aged > 60 years (P < 0.05). Based on the criteria of the Joint Interim Statement and International Diabetes Federation, the prevalence of MetS was higher among women than in men aged > 55 years (P < 0.001). Men had a higher prevalence of MetS without central obesity than women in all age groups (P < 0.001). The odds ratio for MetS and MetS components with aging was greater among women than in men.ConclusionsMedical management should be based on the prevalence of MetS and its components according to sex and age. In particular, the high prevalence of MetS without central obesity in middle-aged and older Japanese men suggests that the adoption of the Joint Interim Statement criteria, which do not precondition central obesity, should be considered.

Predictive estimation of the Visceral Adiposity Index (VAI) and Dysfunctional Adiposity Index (DAI) for metabolic syndrome in a working population

To evaluate metabolic syndrome using three methodsproposed by recognizedinternational institutions, and the visceraladiposity (VAI)anddysfunctionaladiposity (DAI)indices for prediction and prevalence estimation in working populations. Cross-sectional study in workers from different Spanish autonomous communities who underwent a health examination between January 2019 and September 2021 at four occupational risk prevention services. Metabolic syndrome was evaluated according to criteria from the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III), the International Diabetes Federation (IDF) and the Joint Interim Statement (JIS). VAI and DAI values were calculated using their specific formulas and their predictive capacity was measured using ROC curves. The SPSS 27.0 program was used, with statistical significance level set at p< 0.05. 418 343 workers were included, mostly men (58.8%), average age between 30 and 49 years (58.0%), social class III, mostly manual workers (75.9%) and nonsmokers (66.9%). The prevalence of metabolic syndrome differed depending on the criteria used, being higher in men with IDF and JIS, and in women with ATPIII. For the three definitions of metabolic syndrome, the values of the area under the curve were > 0.8 (>80%). The highest VAI was obtained with the JIS, and the highest DAI with the ATPIII. The highest confidence index was for ATPIII and JIS. The VAI and ICD adiposity indices show high predictive capacity in metabolic syndrome with all three criteria used and can be useful for prevention activities in occupational health.